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Also From Kaplan NursingBooksNCLEX-RN PrepNCLEX-RN Content Review GuideThe Basics: A Comprehensive Outline of Nursing School ContentNCLEX-RN Drug GuideAdult CCRN PrepFamily Nurse Practitioner Certification Prep PlusDosage Calculation WorkbookTalk Like a NurseOnlineKaplan NCLEX-RN Qbank

Table of ContentsNCLEX-RN Prep PlusCoverAlso from Kaplan NursingTitle PageCopyrightAbout the AuthorsFor Any Test Changes Or Late-Breaking DevelopmentsReaders’ CommentsHow To Use This BookSign Up For An Online Classroom EventPart 1: NCLEX-RN Exam Overview and Test Taking StrategiesChapter 1: Overview of the NCLEX-RN ExamWhat Is the NCLEX-RN Exam?Content of the NCLEX-RN ExamChapter 2: General and Computer Adaptive Test StrategiesStandardized ExamsWhat Behaviors Does the NCLEX-RN Exam Test?Strategies That Don’t Work on the NCLEX-RN ExamBecoming a Better Test TakerNCLEX-RN Exam Question TypesAlternate Format Test QuestionsMultiple-Choice Test QuestionsCritical Thinking StrategiesReword the QuestionEliminate Incorrect Answer ChoicesDon’t Predict AnswersRecognize Expected OutcomesRead Answer Choices to Obtain CluesChapter 3: NCLEX-RN Exam StrategiesThe NCLEX-RN Exam Versus Real-World NursingStrategies for Priority QuestionsStrategies for Management of Care QuestionsStrategies for Positioning QuestionsStrategies for Communication Questions

Your NCLEX-RN Exam Study PlanPart 2: NCLEX-RN Exam Content Review and PracticeChapter 4: Safe and Effective Care Environment: Management of CareAdvance Directives/Self-Determination/Life PlanningAdvocacyAssignment, Delegation, and SupervisionCase ManagementClient RightsCollaboration with Interdisciplinary TeamsConcepts of ManagementConfidentiality/Information SecurityContinuity of CareEstablishing PrioritiesEthical PracticeInformation TechnologyInformed ConsentLegal Rights and ResponsibilitiesOrgan DonationPerformance Improvement (Quality Improvement)ReferralsChapter QuizChapter Quiz Answers and ExplanationsChapter 5: Safe and Effective Care Environment: Safety and InfectionControlSafety BackgroundInfection Control BackgroundAccident/Error/Injury PreventionEmergency Response PlanErgonomic PrinciplesHandling Hazardous and Infectious MaterialsHome SafetyReporting of Incident/Event/Irregular Occurrence/VarianceSafe Use of EquipmentSecurity PlanStandard Precautions/Transmission-Based Precautions/SurgicalAsepsisUse of Restraints/Safety DevicesChapter QuizChapter Quiz Answers and Explanations

Chapter 6: Health Promotion and MaintenanceAging ProcessAnte/Intra/Postpartum and Newborn CareDevelopmental Stages and TransitionsHealth Promotion/Disease PreventionHealth ScreeningHigh-Risk BehaviorsLifestyle ChoicesSelf-CareTechniques of Physical AssessmentPrinciples of Teaching/LearningChapter QuizChapter Quiz Answers and ExplanationsChapter 7: Psychosocial IntegrityAbuse/NeglectBehavioral InterventionsChemical and Other Dependencies/Substance Use DisorderCoping MechanismsCrisis InterventionCultural Awareness/Cultural Influences on HealthEnd of Life CareFamily DynamicsGrief and LossMental Health ConceptsReligious and Spiritual Influences on HealthSensory/Perceptual AlterationsStress ManagementSupport SystemsTherapeutic CommunicationTherapeutic EnvironmentThe Nursing Process and Psychosocial IntegrityChapter QuizChapter Quiz Answers and ExplanationsChapter 8: Physiological Integrity: Basic Care and ComfortAssistive gical Comfort InterventionsNutrition and Oral Hydration

Personal HygieneRest and SleepChapter QuizChapter Quiz Answers and ExplanationsChapter 9: Physiological Integrity: Pharmacological and ParenteralTherapiesAdverse Effects/Contraindications/Side Effects/InteractionsBlood and Blood ProductsCentral Venous Access DevicesDosage CalculationExpected Actions/OutcomesMedication AdministrationParenteral/Intravenous TherapiesPharmacological Pain ManagementTotal Parenteral NutritionChapter QuizChapter Quiz Answers and ExplanationsChapter 10: Physiological Integrity: Reduction of Risk PotentialChanges/Abnormalities in Vital SignsDiagnostic TestsLaboratory ValuesPotential for Alterations in Body SystemsPotential for Complications of DiagnosticTests/Treatments/ProceduresPotential for Complications from Surgical Procedures and HealthAlterationsSystem-Specific AssessmentsTherapeutic ProceduresChapter QuizChapter Quiz Answers and ExplanationsChapter 11: Physiological Integrity: Physiological AdaptationAlterations in Body SystemsFluid and Electrolyte ImbalancesHemodynamicsIllness ManagementMedical EmergenciesPathophysiologyUnexpected Response to TherapiesChapter Quiz

Chapter Quiz Answers and ExplanationsPart 3: The Practice TestPractice TestYour Practice Test ScoresPractice Test: Answer KeyPractice Test: Answers and ExplanationsPart 4: The Licensure ProcessChapter 12: Application, Registration, and SchedulingHow to Apply for the NCLEX-RN ExamTaking the ExamChapter 13: Taking the Test More Than OnceYou Are Not AloneHow to Interpret Unsuccessful Test ResultsShould You Test Again?How Should You Begin?Chapter 14: Essentials for International NursesNCLEX-RN Exam Administration AbroadThe CGFNS CertificateWork VisasNursing Practice in the United StatesU.S.-Style Nursing CommunicationSample QuestionsSample Questions: Answers and ExplanationsLanguageKaplan Programs for International NursesPart 5: NCLEX-RN Exam ResourcesAppendix A: Summary of Critical Thinking PathsAppendix B: Nursing TerminologyAppendix C: Common Medical AbbreviationsAppendix D: State Boards of Nursing

NCLEX-RN Prep Plus20182 Practice Tests Proven Strategies Online Video

NCLEX-RN is a registered trademark of the National Council of State Boards of Nursing, which neithersponsors nor endorses this book.This publication is designed to provide accurate information in regard to the subject matter covered asof its publication date, with the understanding that knowledge and best practice constantly evolve. Thepublisher is not engaged in rendering medical, legal, accounting, or other professional service. Ifmedical or legal advice or other expert assistance is required, the services of a competent professionalshould be sought. This publication is not intended for use in clinical practice or the delivery of medicalcare. To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for anyinjury and/or damage to persons or property arising out of or related to any use of the materialcontained in this book. 2018 by Kaplan, Inc.Published by Kaplan Publishing, a division of Kaplan, Inc.750 Third AvenueNew York, NY 10017

ABOUT THE AUTHORSBARBARA IRWIN, MSN, RNBarbara is emeritus Executive Director of Nursing at Kaplan Test Prep. Shesupervised development of the Kaplan courses for preparation for the NCLEXRN examination for U.S. nursing students and international nurses, as well asintegrated testing programs implemented by nursing schools. Irwindeveloped the Decision Tree, a framework of innovative test-taking strategiesthat help students achieve success on this high-stakes test. Her seminarsabout how to effectively study to achieve deep learning have guidedthousands of student nurses. Her seminars to nursing faculty have sharedimportant insights about the NCLEX-RN and NCLEX-PN examinations andhow to overcome the challenge of non-self-efficacious nursing students. Irwinreceived a bachelor of science in nursing from the University of Oklahoma anda master of science degree in nursing and nursing education from KaplanUniversity. Her professional background includes experience as a nursingeducator and director of a home health agency.JUDITH A. BURCKHARDT, PhD, MSN, RNDr. Judith Burckhardt is former Dean of the Nursing and Health Programs forKaplan Higher Education Campuses, Vice President of the Kaplan School ofNursing, and head of the Nursing division at Kaplan Test Preparation. UnderDr. Burckhardt’s leadership, Kaplan introduced new methods of programprovision, including online delivery. She is currently Dean of NursingPrograms at American Sentinel University. She also presents test preparation

seminars to students, item-writing workshops to nursing faculty, and careerdevelopment seminars to students, nurses, and healthcare professionals inthe United States and abroad. Dr. Burckhardt received a bachelor of science innursing from Loyola University in Chicago, a master’s degree in educationfrom Washington University in St. Louis, a master of science in nursing degreefrom Kaplan University, and a doctorate in educational administration fromthe University of Nebraska at Lincoln.Kaplan thanks the following nursing professionals for their contributions to thisbook:Barbara Arnoldussen, RN, MBA, CPHQShawna M. Butler, RN, BSN, JDTamara Dolan, RN, MSN, OCNTerri Forehand, RNConstance Krueger, RNRene Jackson, MS, BSN, RN, LHRM, CPHRM

FOR ANY TEST CHANGES OR LATEBREAKING DEVELOPMENTSkaptest.com/publishingThe material in this book is up-to-date at the time of publication. However,the National Council of State Boards of Nursing may have instituted changesin the test after this book was published. Be sure to carefully read thematerials you receive when you register for the test. If there are any importantlate-breaking developments—or any changes or corrections to the Kaplan testpreparation materials in this book—we will post that information online atkaptest.com/publishing.

READERS’ COMMENTSHere’s what our readers have to say about Kaplan’s NCLEX-RN examguide:“I was the classic unsuccessful test taker when I started your book. When I wasdone, I had become a successful test taker. I took my NCLEX-RN exam andpassed on the first attempt. I credit Kaplan with that.”—A. Duane Deyo, Stafford, VA“The questions in the review book were just like the ones on the test. The tips onhow to take the exam really helped me. I took my NCLEX-RN exam and passedthe first time!”—Heather G. Sabott, Egg Harbor Township, NJ“Thank you, Kaplan. This book, test, and strategies really helped me getthrough my boards. I passed on my first attempt with only 75 questions. Yourprogram definitely prepares the student for success.”—Deirdre A. Beasley, Rancho Cucamonga, CA“The book is very user-friendly, well organized, and very comprehensive. It gave me more self-confidence in answering NCLEX-RN exam questions. Twothumbs up!”—G. B. Perdigones, Chicago, IL“After doing all my reviews, I read this book twice and I went to take the testwith confidence. I did it—thank you!”

—Elisabeth Boursiquot, Spring Valley, NY“Out of the 15 NCLEX-RN books I bought, this Kaplan book was the only onethat helped. The critical thinking and test taking skills were very useful instudying for the NCLEX-RN exam. Thank you so much!”—Sherrie Corcuera, Barnegat, NJ“I had taken the NCLEX-RN exam twice and failed, I’d taken courses, etc. Ididn’t need another study book—I needed a book that emphasizes test takingskills for NCLEX-RN exam and test anxiety reduction. I took the test for the thirdtime and passed!”—Beatrice Ordoñez, O’Fallon, MO“I am a foreign-educated nurse On my exam day I was so confident andpassed the first time. Thank you.”—Nimfa C. Garrison, Raritan, NJ“Before I started to prepare for the NCLEX-RN exam, I started with this book(I’m a foreign nurse from Switzerland), and it really helps me to have a criticalthinking strategy and to answer the NCLEX-RN exam question types. Thepractice test and the answer key are extremely helpful, the way it explains everysingle answer. So now, I think I’m ready to start the Kaplan course book. Thankyou.”—Celine Cucchia, San Jose, CA“Special thanks to the creators of this wonderful book and others related toNCLEX-RN exam. It was the best I could ever have gotten. I just feel sorry I didn’ttake your review class due to [the fact that] I didn’t know about you guys untilafter I took another review class. But I was lucky to find this wonderful book.Thanks! I will recommend this book or anything related to Kaplan to the future

generations of my nursing school. You guys are the best! Thank you and keep upwith the good work.”—Elvia Manrique, Port Jefferson Station, NY“My husband gave me this book for Christmas and it was one of the best gifts Iever received. By reading your book cover to cover, I gained some confidence,learned how to reword questions, how to correctly read a question, and how todecrease some of my anxiety. Thank you for a great book that I will definitelyrecommend to anyone taking the boards.”—Nancy D. Zimmerman, South Windsor, CT“This book was a blueprint to the NCLEX-RN exam. I passed the test on the firsttry. Everything that was explained in the book was actually on the test.”—Jacquelyn Claude, Suffolk, VA“I plan to call my school and recommend this book!”—Nicole Sary, East Peoria, IL“Reading the book was like an instructor talking. The book is absolutelyGREAT!”—Lianna Williams, Bronx, NY“Very easy to understand—MADE SENSE. Everything about this book wasexceptional. After my self-esteem dropped when I found out I failed the firsttime, I didn’t know what to do .This book, I felt, was easy to understand, andwhen I went to take my test a second time, I walked out with confidence. Thestrategies in this book are why I am an RN today. Thank you so much!”—Dana Adams, Fort Worth, TX“Truly an indispensable review for every internationally educated nurse!”

—Lamberto F. Valera, RN, MAN, Jordan Valley, Israel“Thank you, Kaplan, for this book!”—Dawn Nicole Lake Prince, Van Nuys, CA“I bought [the] Kaplan textbook when I was preparing for [the] NCLEX-RN examlast month. I was a foreign-trained nurse so I was finding it hard to answerNCLEX-RN exam questions. The book helped me a lot. I recommend thisKaplan study guide to everybody preparing for the NCLEX-RN exam.”—Ngozi Uketui, AR

HOW TO USE THIS BOOK

SIGN UP FOR AN ONLINE CLASSROOMEVENTKaplan’s NCLEX-RN online classroom sessions are interactive, instructor-ledNCLEX‑RN prep lessons that you can participate in from anywhere you canaccess the Internet.The online sessions are held in a state-of-the-art virtual classroom—actuallessons in real time, just like an in-person classroom experience. Interact withyour teacher and other classmates using audio, instant chat, whiteboard,polling, and screen-sharing functionality. And as in a Kaplan Nursing courseheld in person, an NCLEX-RN online classroom session is led by anexperienced Kaplan instructor.To register for your NCLEX-RN online classroom session:Go to kaptest.com/NCLEXRNPrepPlus2018 and sign up for the onlinecenter. See “How to Use This Book” for more information on how to signup.Once you’ve signed up for the online center, sign in to “My Courses” andclick on “NCLEX-RN Prep Plus 2018” to drop down your Course Syllabus.Select the tab “Free Practice” and scroll down to “NCLEX-RN” to see thedates and times of upcoming NCLEX-RN online classroom events.Select a date for your live classroom event by clicking “Sign Up.” Aseparate window will appear with registration instructions. You will receivea confirmation email recording the date and time of your event.

Prior to attending the event, please check your computer settings byreviewing the system requirements and running the tech check. You maybe prompted to install the Adobe Connect plug-in.On the day of your free classroom event, sign in to your StudentHomepage. You can enter Kaplan's virtual classroom up to 15 minutesbefore the scheduled start time.Please note: Registration begins one month before the session date. Be sureto sign up early, since spaces are reserved on a first-come, first-served basis.

PART 1NCLEX-RN EXAM OVERVIEW ANDTEST TAKING STRATEGIES

CHAPTER 1OVERVIEW OF THE NCLEX-RN EXAMThe NCLEX-RN exam is, among other things, an endurance test, like amarathon. If you don’t prepare properly, or approach it with confidence andrigor, you’ll quickly lose your composure. Here is a sample, test-like question:A man had a permanent pacemaker implanted one year ago. Hereturns to the outpatient clinic because he thinks the pacemakerbattery is malfunctioning. It is MOST important for the nurse toassess which of the following?1.2.3.4.Abdominal pain, nausea, and vomitingWheezing on exertion, cyanosis, and orthopneaPeripheral edema, shortness of breath, and dizzinessChest pain radiating to the right arm, headache, anddiaphoresisAs you can see, the style and content of the NCLEX-RN exam is unique. It’snot like any other exam you’ve ever taken, even in nursing school!The content in this book was prepared by the experts on Kaplan’s Nursingteam, the world’s largest provider of test prep courses for the NCLEX-RN

exam. By using Kaplan’s proven methods and strategies, you will be able totake control of the exam, just as you have taken control of your nursingeducation and other preparations for your career in this incrediblychallenging and rewarding field. The first step is to learn everything you canabout the exam.

What Is the NCLEX-RN Exam?NCLEX-RN stands for National Council Licensure Examination-RegisteredNurse. The NCLEX-RN examination is administered by the National Council ofState Boards of Nursing (NCSBN), whose members include the boards ofnursing in each of the 50 states in the United States, the District of Columbia,and four U.S. territories: American Samoa, Guam, the Northern MarianaIslands, and the Virgin Islands. These boards have a mandate to protect thepublic from unsafe and ineffective nursing care, and each board has beengiven responsibility to regulate the practice of nursing in its respective state.In fact, the NCLEX-RN exam is often referred to as “the Boards” or “StateBoards.”The NCLEX-RN exam has only one purpose: to determine if it is safe for you tobegin practice as an entry-level nurse.WHY MUST YOU TAKE THE NCLEX-RN EXAM?The NCLEX-RN exam is prepared by the NCSBN. Each state requires that youpass this exam to obtain a license to practice as a registered nurse. Thedesignation registered nurse or RN indicates that you have proven to yourstate board of nursing or regulatory body that you can deliver safe andeffective nursing care. The NCLEX-RN exam is a test of minimum competencyand is based on the knowledge and behaviors that are needed for the entry-

level practice of nursing. This exam tests not only your knowledge, but alsoyour ability to make competent nursing judgments.WHAT IS ENTRY-LEVEL PRACTICE OF NURSING?In order to define entry-level practice of nursing, the National Councilconducts a job analysis study every three years to determine what entry-levelnurses do on the job. The kinds of questions they investigate include: In whichclinical settings does the beginning nurse work? What types of care dobeginning nurses provide to their clients? What are their primary duties andresponsibilities? Based on the results of this study, the National Counciladjusts the content and level of difficulty of the test to accurately reflect whatis happening in the workplace.WHAT THE NCLEX-RN EXAM IS NOTIt is not a test of achievement or intelligence. It is not designed for nurses whohave years of experience. The questions do not involve high-tech clinicalnursing or equipment. It is not predictive of your eventual success in thecareer of nursing. You will not be tested on all the content that you weretaught in nursing school.WHAT IS A CAT?CAT stands for Computer Adaptive Test. Each test is assembled interactivelybased on the accuracy of the candidate’s response to the questions. Thisensures that the questions you are answering are not “too hard” or “too easy”for your skill level. Your first question will be relatively easy; that is, below the

level of minimum competency. If you answer that question correctly, thecomputer selects a slightly more difficult question. If you answer the firstquestion incorrectly, the computer selects a slightly easier question (Figure 1).By continuing to do this as you answer questions, the computer is

Kaplan Higher Education Campuses, Vice President of the Kaplan School of Nursing, and head of the Nursing division at Kaplan Test Preparation. Under Dr. Burckhardt’s leadership, Kaplan introduced new methods of program provision, including online delivery. She is currently Dean of Nursing Programs at American Sentinel University.

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